Provider Demographics
NPI:1437433505
Name:BINKLEY, LISA L (LMT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:BINKLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 ZOLLINGER RD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2850
Mailing Address - Country:US
Mailing Address - Phone:614-442-6754
Mailing Address - Fax:614-442-6737
Practice Address - Street 1:1840 ZOLLINGER RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2850
Practice Address - Country:US
Practice Address - Phone:614-442-6754
Practice Address - Fax:614-442-6737
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016080172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist